28^th Euro Dentistry Congress September 16-17, 2019 Amsterdam, Netherlands
Park Plaza Amsterdam Airport Hotel

Periodontitis is a highly prevalent and complex disease, initiated by a dysbiotic biofilm but progressed largely by an exaggerated under-regulated host immune-inflammatory response. Its primary features include the loss of periodontal tissue support of the tooth, manifested through clinical attachment loss and radiographically assessed alveolar bone loss, presence of periodontal pocketing and gingival bleeding. Periodontitis could increase the systemic inflammation in patients with CVD due to bacteremias with periodontal origin. A male patient, 47, was presented to the University San Sebastian at Concepción, Chile, School of Dental Clinic on June 01, 2016 for oral and periodontal examination. The patient's medical history included dyslipidemia (DLP), coronary heart disease (CHD), acute coronary syndrome (ACS), angina and history of myocardial revascularization surgery in 2013. Full-mouth probing depths showed overall pockets up to 8 mm. Loss of attachment levels were in the range of 8 mm. The periodontal examination described the gingival margins as erythematous and edematous, with multiple periodontal abscesses, increased tooth mobility and furcation involvement. Radiographic evaluation showed severe alveolar bone loss. The diagnosis was generalized as severe chronic periodontitis. The nonsurgical periodontal treatment included scaling and root planning (SRP), local treatment with chlorhexidine and systemic treatment with amoxicillin and metronidazole. The treatment was successful with significant improvement of periodontal parameters. However, during 2017, it was not possible to continue the treatment due to worsening of the cardiovascular condition, in this case a new acute coronary syndrome (ACS) that was treated with angioplasty placing two medicated stent. Another acute episode of the coronary disease happened the same year and was treated with another angioplasty with balloon catheter. Drugs in use were: clopidogrel-75 mg day, carvedilol-3.125 mg bid, atorvastatin-80 mg at night, aspirine-100 mg day and enalapril-10 mg bid. Even with local and systemic drug treatment, aimed at prevention of systemic bacteremia due to the invasive periodontal procedures, the patient underwent a ACS, suggesting a possible antecedent infection link to a vascular plaque, leading to subsequent plaque destabilization, rupture and ACS. Despite the systemic condition, a maintenance non-invasive management of periodontitis was possible, avoiding its progression.

Areej Ayed Derham has completed her BDS from King Abdulaziz University, Faculty of Dentistry. She is a seasoned dentist with experience in all phases of four-handed dentistry. Successfully challenged the global board of human development and became a dimplomate in both Applied Psychology and Sign Language. Member of International Association of Dental Research, Behavioral, Epidemiologic and Health Services, and Arab Society for Disability and Oral Health. Recently joined the Global Oral Health Inequalities Research Network. She has several ISI publications and presented them in well-organized conferences. Currently she is working on several papers and contributing too many others.

Aim: This article aims to present an advanced therapeutic approach based entirely on adhesive dentistry. Background: The restoration of endodontically-treated teeth (ETT) has been widely and controversially discussed in the dental literature, most of which recommends cuspal coverage of ETT to protect against potential tooth fracture. The main goal of conservative dentistry in managing ETT is to achieve minimally invasive preparation with maximal cuspal coverage. The “endocrown” follows this rationale. In addition, proximal caries with deep cervical margins are particularly complex to manage clinically. Moreover, there are various clinical approaches to such challenges, such as placing a base of composite resin to coronally displace proximal margins underneath indirect bonded restorations as known as deep margin elevation (DME) or coronal margin relocation. Case Description: This study is a clinical case report of an endocrown restoration performed on ETT with extensive coronal destruction. In combination with the clinical procedure presented here, some of the ETT with deep cervical margins were managed by applying direct composite resin restoration using the DME technique. Conclusion & Clinical Significance: The ideal treatment of ETT has been controversially discussed in the literature. Based on current evidence, endocrowns can be considered as a reliable treatment option for moderately mutilated ETT. The achieved adhesive monoblock system reduces the need for macro-retentive geometry and provides an efficient outcome and better esthetics. Furthermore, the DME technique represents another useful treatment approach for patients with financial restrictions and those with higher risk of negative outcomes involving more invasive surgical procedures. Thus, it could be used in clinical situations with deep subgingival cervical margin where isolation with a rubber dam remains possible.

Rumeysa Cihangir was graduated from Istanbul University, Faculty of Dentistry and she is a PhD student at Istanbul University, Faculty of Dentistry, Department of Periodontology. Her PhD dissertation will be about neutrophil enzyme alterations of gingival crevicular fluid at smoker gingivitis patients. This study is still on progress. She has participated in many domestic congresses.

Objective: Papillon Lefevre Syndrome (PLS) is an autosomal recessive inherited genetic disorder characterized by palmoplantar hyperkeratosis and premature loss of deciduous and permanent teeth. Mutation of cathepsin C gene has been detected in the patient with PLS. In this case report, oral and radioghaphic findings of one PLS patient were discussed. Case: Fourteen year old male patient diagnosed with PLS after radiographic, dermatologic and dental examination was referred to our clinic due to severe gingival inflammation and mobility. Severe gingival inflammation, alveolar bone resorption and multiple teeth loss due to periodontal reasons were observed. Mild palmar and moderate plantar hyperkeratosis was observed but no other systemic problems were detected. After non-surgical periodontal treatment and antibiotherapy severe gingival inflammation was reduced but not eliminated completely, mobility score of some teeth reached to zero score; patient was motivated about oral hygiene and was taken into maintenance phases. After having extracted hopeless teeth patient was directed for prosthodontic rehabilitation. Conclusion: PLS is a rare autosomal recessive disorder. With PLS-specific dermatologic findings and characteristic periodontal view, it is possible to be able to identify the disease in its very early stages. Early diagnosis of the disease and institution of an appropriate periodontal and antimicrobial treatment might improve the prognosis.

Introduction: Human saliva is a fluid with many biological functions essential for the maintenance of oral health.[1] Salivary flow and composition influences calculus formation and periodontal disease. Salivary calcium, magnesium due to its affinity to be readily taken up by plaque, is an important factor not only with regard to the onset of periodontitis but also significantly with regard to dental health. They are one of the most intensely studied potential markers for periodontal disease in saliva.[2,3] Cross-sectional and longitudinal studies have provided strong evidence that smoking is a significant risk factor for periodontal disease.[4] All of the surveys have reported increased quantities of calculus in smokers. It has long been known that smoking causes a marked increase in salivary flow rate as a simple reflex effect and this could explain the tendency of smokers to accumulate increased amounts of calculus. There is some evidence that smoking also increases the mineralizing potential of saliva [4]. An elevated level of salivary calcium in smokers is related to a greater degree of bone loss and lower mineral density of bones than in non-smokers [5,6] Smokers have comparatively higher oral pH than non-smokers. Therefore, there is a great possibility for this pH to extract calcium from the scales deposited on the teeth (or even from their teeth) of these individuals which might result in the elevated levels of salivary calcium, magnesium level.[6] Aims & Objectives: To estimate, analyze, compare and to correlate the variation in salivary calcium, magnesium levels and pH in periodontally healthy subjects and that of chronic periodontitis of smoker and non-smoker subjects. Results: • The mean PPD score is significantly higher among smokers than non-smokers (p<0.05). • The mean salivary calcium level is significantly higher among smokers than non-smokers (p<0.05). • There were no statistically significant differences in PI, GI, salivary magnesium and pH among smokers than non-smokers (p>0.05).